Is Obamacare About to Skyrocket Your Health Care Costs?

"If you think health care is expensive now, just wait until you see what it costs when it's free!"-- P.J. O'Rourke, The Liberty Manifesto (1993).

I've heard this clever quip about health care reform many times before, but this quote by P.J. O'Rourke was supposed to prove meaningless thanks to the passing of the Affordable Care Act in 2010... right?

Crafted by President Obama and lawmakers, the ACA, also known in shorthand as Obamacare, was to create a competitive pool of insurance companies competing for consumers' premium dollars which would help drive the costs of medical care and premiums lower. In addition to creating these pools, the ACA:

Required insurers to spend at least 80% of patient premiums on care or return the difference.

Would not allow insurers to turn away patients with pre-existing conditions.

Would expand the existing pool of qualifying government-sponsored Medicaid patients.

Would establish a medical device excise tax that would collect 2.3% of revenue from all medical device makers to help pay for the Medicaid expansion.

Would mandate individuals to carry health insurance.

Remember those savings? Yeah, not so fast... Despite these sweeping reforms, the Society of Actuaries released a report (link opens PDF) this month showing that the ACA-driven costs associated with non-group members participating in the insurance pools are set to see an average increase of 32% in underlying claims costs by 2017. It's true this report didn't take into account the effects of pool pricing competition and focuses solely on non-group participants (those not covered by employers), but it's still very concerning as actuaries are often conservative in their estimates.

Sure, the SOA's report demonstrated strength in certain states, with five expected to see underlying claims costs drop. However, that means costs are expected to rise in the remaining 45 states, with 37 of those states expecting costs to jump by 20% or more. According to the SOA's report, Ohio and Wisconsin can expect their claims costs to jump by 80% or more.

This leads me to question whether our medical costs are about to soar under Obamacare?

Not an encouraging start The precursors to Obamacare going into full effect next year haven't been encouraging. Medical device manufacturer Stryker (NYSE: SYK) cut its workforce by 5% in direct response to the added costs of the medical device excise tax while the CEO of NuVasive (NASDAQ: NUVA) , Alexis Lukianov, threatened to move his research and development operations overseas because of the device tax last June. Similarly Medtronic (NYSE: MDT) , the largest medical device maker in the world, has been investing heavily in China in order to take advantage of cheap labor and a more favorable tax situation.

The CEO of insurer Aetna (NYSE: AET) , Mark Bertolini, had this to say about the potential for premium price hikes in anticipation of the full implementation of Obamacare in 2014: "We've all done the math, we've shared it with regulators, we've shared it with all the people in Washington that need to see it, and I think it's a big concern."

That didn't stop Aetna from hiking premiums by as much as 21% in some states last year in anticipation of pricing caps soon to be put in place by Obamacare.

The negative effects, though, extend far beyond the medical sector. Papa John's (NASDAQ: PZZA) CEO John Schnatter heavily criticized the costs associated with Obamacare last year, riling up consumers after parceling out its precise costs to the company at $0.11 to $0.14 per pizza.

Don't get me wrong -- there are some very clear positives derived from health-care reform, including some 32 million people that were previously uninsured gaining insurance under Obamacare. That's progress, as is the fact the quality of coverage should improve in some cases from a bare-bones policy to something more encompassing.

Still, this report from the SOA wasn't an encouraging read and could put the President and the entire health care industry on the defensive until proven otherwise.

What's your take on Obamacare? Is this good for America, a necessary evil, or a failure from the get-go? Share your thoughts in the comments section below.

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Fool contributor Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.

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Look, 30 million people, who are currently uninsured, are about to become insured. Yes, that's going to cost money. Whose money will it be? Ours. Yours and mine. Yes, it's going to cost US money.

But only the most idiotic fool would think we're not already paying for those 30 million uninsured people. They're getting sick, and need medical care. They're currently not getting it until they become critical and go the emergency room, where the law requires they get treated. Who picks up that tab? We do. You and me, Mr. and Mrs. Taxpayer.

So is it cheaper to treat a person with diabetes by giving him the health care he needs to keep himself on an even keel on a daily basis, or to wait until he goes into a diabetic coma, have him rushed to the OR, and nurse him back to health time and time again, until he dies? I know how I'd rather spend MY taxpayer dollars.

There must be people out there somewhere that believed that the "Affordable" Care Act would reduce costs while improving health care access. Outside of Democrats in the Congress, who were these people? The only coherent response that I have gotten from my Democratic friends is that the law sucks because the Republicans wouldn't allow passage of a better one. True or not, it doesn't change the fact that the law sucks. IT SUCKS BECAUSE IT SUCKS.

It is interesting that the Society of Actuaries is predicting a 32% increase in non-group premiums.

As alarming as that prediction is, it does not take in account another profound impact that PPACA will have on small group coverage.

Beginning in 2014 small group medical plans will be subjected to a deductible cap - these plans will not be permitted to have an individual deductible above $2,000.

I would submit to you that this will impact up to 59% of small group PPO plans and nearly 90% of the HDHP/HSA plans. Employers and employees will both see their premiums increase because of the forced reduction in deductible.

Many of these employees will choose to leave their group plan and go to the individual market (where the deductible cap is not required) - where as the Society of Actuaries predicts - their premiums will increase by up to 32%

Health care companies are big business and they all voted against Obama. Now it is payback time and they will do anything to get back at him and the more than half of Americans who also voted for him. They will play with the numbers just so they can rub it in our faces. I predicted this if Obama won. So what is new!

The real power here will be with the Doctors, hospitals Ect. They control the costs and if they will take your insurance. If it is Govt or Priviate if they refuse to take the insurance you will not be taken care of.

Now you add all the Sick people not just regular cancer type illnesses, but drug users, Acholics, Aids, mental illness, with no age bands and with no limits you will have higher prices and you force the people to purchase too.

It is simple math, divide the number of people into a cost of medicine and you have a preium. But we cannot come up the cost of medical procedures because the medical community charges are all over the place for same procedures. You have to fix these costs to come up with the correct math. That is why nobody knows what is going to happen except that it will be really expensive. Aetna said it correctly we gave them the numbers the Govt just won't tell you the number until this fall. When it is to late to turn back.

We have a at home war and it is healthcare cost. If any business or trade can not support a service at a reasonable cost they sellout or go bankrupt. It is that time. If we can spend billions on wars, equipment and training. Serving your country needs to be educated doctors , train to take over the healthcare needs of this country. These billion dollar insurance companies and the million dollar doctor is something this country can no longer afford.

Insurance isn't supposed to be a third party payer. Insurance is supposed to protect against large economic losses. If your homeowner's insurance was like health insurance, it would pay to paint your front door and mow your yard. Health insurance should protect against large bills, and not pay for flu shots and annual exams.

The ACA is anything but affordable. Insurance companies make about 3.5 cents profit on every premium dollar. ACA put a hard cap on what profit could be made with the requirement to spend 80 cents of every dollar on medical care. The swine flu caused most insurance companies to over spend on medical care. With the new cap they can’t get back to healthy the next year. How long before they are regulated out of business?

The minimum plans have more benefits than most people carry now. If I had to pay the total cost of insurance (I did when unemployed) I would not chose the new minimum plans as they are too costly.

Tax the device makers to raise revenue to help pay for ACA. Is there anyone that thinks the device makers won’t pass the cost onto us?

Doctors are being forced to accept less for services rendered. Would you continue to work if I told you each year I am going to decrease your salary?

It will get medical care for millions. The whole act is about taking money from all of us to pay for care for some. I have enough trouble paying for my family; I really can’t afford to pay for someone else. The problem is it will destroy the at least one of the following: US, medical insurance companies, doctors or citizens.

I noticed where peter chipman wrote that his democratic friends said Obama had to pass this because the republican would not pass anything better. He needs to check who his friends are. Yes blame Obama care on the republicans (sounds about right don't it)

We all must remember that the republicans were shut out of the passing of this bill. The democrats must take full blame for Obama care they can't blame it on anybody and by the way can't blame it on George Bush.People and the democrats must open their eyes and stop Obama in his tracks before there is no turning back.

Somebody please name something that the government provides in a cost effective way. This program will follow the same path. The people who do not have coverage by and large don't because they can't afford it. What about this plan will change that?

Regulate prices, we tried that in the 70's it does not work and leads to shortages and black markets. I lived through that, I don't want to ever again!

All I know is that my husband and I were both working almost 40hrs a week and now we are cut down to under 30 each. The companies we work for did not want or couldn't pay for heath insurance. How are we going to afford health insurance if we lost so many hours and are now barely living paycheck to paycheck. Yes we have looked for other jobs, but it isn't easy to find one to work around the one you have now. I am also a full time student at an university. I can't take a 2nd job, only my husband can. I really don't want to apply for government assistance, but we will probably have to.

Something needed to be done but I'm not sure this was it. Middlenamefrank hit the nail on the head. When sick people use ERs as doctor's offices, they are not turned away and we all pay for that. That was happening before Obama even considered running for office. Just like any other business, if a hospital can't pay the bills or keep the lights on, it will close. Then we all lose. And clouding the issue with comments about paying people's mortgages and buying their groceries are ignorant and useless. The topic is HEALTHCARE not mortgages or grocery prices. Try to stay on topic, dingbats. This isn't about keeping drug addicts high, it's about all of us having access to care.

A large number of burn units in this country are experiencing financial difficulty or closing completely b/c a large number of burn victims are uninsured meth addicts who got burned making their meth. When a burn unit closes, that means that someone who faces a serious burn injury from some other (legal and/or non drug related) means will have to travel further to receive care. This wastes valuable time. Lives will be adversely affected or lost b/c of the delay in treatment.

For the first time in generations, quality of life and average life expectancy are declining. And yet treatment and healthcare costs are increasing. Something has to change or the US will decline from 1st world to 3rd world status. The future is not so bright...

The whole thing is very unfortunate. I feel for the person who had their hours cut back, but unfortunately that is going to be happening to a lot more folks.

And the cost is going to skyrocket. We've already seen the impact w/i our company.

People who don't make a lot now are going to be required to pay for insurance or a penalty when they don't have $$ to pay their bills already.

A lot of fools out there who voted him in for this. People hear free and thing it will actually be free. Nothing in this world is free and the middle class are the ones who are going to get the brunt of thins.

Ill conceived pile of garbage, which now stands at over 20,000 pages, and about 7 feet tall. No one can possibly understand any of it, so the only solution will be to keep throwing money at the problem. It's really just common sense, isn't it? Creating a multi-billion dollar government bureaucracy to regulate a multi-billion dollar insurance industry creates a multi-trillion dollar tax nightmare for us.

The problem with healthcare was never about insurance, it was about the rising cost of healthcare. The law really only deals with insurance, which is a derivative product, who's cost cannot be realistically legislated. Insurance is not a manufactured product, and will not follow the laws of supply and demand as they naively, or ignorantly, claim. You can't even control the cost of a mandated product. The notion is just absurd. Sure, we needed a few changes in the way insurance companies rejected people, and denied claims, but forcing everyone to buy insurance was not the solution.

The problem with insurance is not the cost, it's the value. The value of insurance as a product has been declining for years, and will continue to decline. In other words, we're paying more and more for less product. What's going to happen is simple. People who never had insurance before, and limited their trips to the doctors, will now be subsidized by taxpayers. Having that insurance will compel them to make MORE trips to the doctor, increasing the rate of claims. That in turn, will result in higher taxpayer costs, and higher premiums to cover the bad debt, because they won't be paying any copay, or their portion.

The problem was healthcare costs, and that's what the bill needed to focus on primarily. You aren't reducing the costs when you're adding substantially more bureaucracy. Hospitals are going to have to hire more indirect labor just to help sift through the growing mountain of regulation handed to them from the ACA bill. Even worse, the government taxed labor saving medical equipment, which in turns raises costs. We pay that tax ultimately in the bill.

This bill is the ignorant leading the blind.

One other factor is going to come into play as well. We're subsidizing the dregs of society, and encouraging them to see a doctor. What's going to follow them? Ambulance chasers. Yes, the cost of litigation is going to rise, and once again, we're going to pickup the tab.

The threats by self serving and predatory corporations regarding their boo-hooing over having to pay for their workers health insurance should not simply be ignored, we as patients and consumers should refuse to accept or purchase a device or service from them.

Corporations have been abandoning America and Americans for years simply out of greed for more executive suite profits and to court investors. This whining about how their windfall profits are more important than how their workers are treated is nothing new.

Their disloyalty to us should be met with our disloyalty to them. We are idiots for pouring money into businesses that produce products in sweatshops and show no loyalty to America or to American workers.

And, as a response to the typically self serving posters above who decry the ACA as simply a foray into NEW TAXES (!!!!!!!), note the following:

1) As so-called fiscally responsible individuals, how is it that you feel care should be delivered to Americans without someone paying for it? These so called 'taxes' in fact pay for care that will be used anyway by Americans who are uninsured and underinsured, including I am sure, many self righteous posters on this column

2) As noted above, the ACA "Required insurers to spend at least 80% of patient premiums on care or return the difference, and would not allow insurers to turn away patients with pre-existing conditions." Since corporate health insurance has been mainly interested in feathering it's own nest at our expense (retiring United Health Care chairman in1998 retired with a $40 BILLION pension plan!!) these changes are long overdue.

The ACA simply implements the saying that, "there is no such thing as a free lunch" and it protects us from vuture capitalists and predatory corporations whose looting of America and Americans has become the norm.

To Middle Name Frank: You say 30 million people are about to buy insurance so they won't be using emergency rooms anymore? Don't you realize if they can't afford it before obamacare is implemented, how are they going to afford it afterwards? I've looked into buying insurance for a single person. The cheapest is $500 a month for a basic plan. I don't have $500. extra a month to buy it. I'm out of work right now and struggling to even keep food on the table. I'm talking spaghetti and rice, a piece of chicken. The illegals use the emergency rooms. They WON'T be buying insurance, either.

You are absolutely right. The other problem with insurance costs is directly related to regulations. Now we're going to be forced to pay for condoms and abortions as well. These are not huge expenses on a personal level, but collectively we're talking billions. Healthcare costs are the issue, not insurance. if we force insurance companies to cover every little incidental, we'll all be paying $1000 month in premiums. I don't need anyone to pay for my condoms, and I certainly wouldn't expect any to pay for an abortion. The government doesn't live in reality though, which should be abundantly clear at this point. Heck, most government workers can retire with full pensions after 20 years. That's one heck of a deal, don't you think? 20 years in the police force, or fire department, out at 40ish, and 40+ more years of pay to not work, with medical! Sign me up!

Look, our so-called US healthcare "system" was the most irresponsible and poorly conceived "system" anywhere in the western world to begin with. Obamacare could have been so much better if only Congress hadn't been bought off and had been prepared to work for the benefit of all Americans, not just corporations. Replace for-profit insurers with private non-profits, subject drug pricing to market forces, set up a subsidy program for those unable to pay and we would have ourselves a real system. It isn't that difficult. Before rebutting at least read "The Healing of America" and Time magazine's "Bitter Pill".

Obama, Pelosi, and Reid couldn't read the Bill. Now we know that they have screwed the poor and the middle class. Meanwhile, the US media supports Obama destroying the poor and the middle class. It is time to switch to an honest news network - not one that supports Odumbo and the Chicago Way.

It's early in 2013. 2017 is 4 years away. Healthcare inflation has been out of control for a long time. 32% increase over 4 years seems pretty typical to me. Sometimes the answer is obvious.....like this time.

Good Lord did I just accidentally click on Glenn Beck's website? I'm shocked at the right wing lunacy on these posts. Oh and Shockazulu good work writing in all caps and suggesting these people return to Africa, cause you know that makes your point so much better than just writing it. I love how right wingers over use the exclamation point, "should I use 4, no I'll use 5, that'll make my point."

Someone wake me up when the Fool stops trying to court the Rush Limbaugh listener and goes back to providing insight about companies.

It was going up 30% a year prior to ACA. Between 2001 and 2008 my insurance costs went up by more than 1,000% and my coverage went down. At this rate, it will only go up around 100% in the same time frame - 1 tenth the cost increase under the old unregulated system.

I didn't realize that this was going to just turn into Obama bashing when I started reading it (although I should have). I am self-employed and I have a pre-existing condition. This means that I have been denied medical coverage by more than my fair share of insurance companies. I found a way to get insurance and the premium is absurd, but I'm dealing with it because I have lived for too long without insurance and it worries me. Having been in this situation I am sick of people referring to the uninsured as somehow being stupid, degenerate, or freeloaders. For some finding insurance is a struggle whether you have the money or not.

I support this bill for a variety of reasons, the most important being that I will be able to get better coverage for less money, and that I am for helping other people who need insurance get it even if it means that I end up subsidizing it.

It is very easy to ignore uninsured people and believe that they are somehow not like everyone else. I am not trying to pull either a democrat or republican thing here, I am simply stating that everyone deserves both acceptable insurance and the peace of mind that comes with having it.

Something else that people may be ignoring is the very real possibility that this will take many people off of Welfare. I don't know if everyone is aware of the trap that Welfare is, but the income restrictions to qualify are so abysmal that even a part time minimum wage job means that you could no longer have insurance, which is something that keeps people who are on it from seeking employment. If you tell people that even if they go out and make some money (but not enough to adequately afford healthcare) then this could represent a significant reduction in other drains on our economy.

There are some added benefits to the idea of healthcare for everyone that people are simply not taking into account.

How many posters realize that we already pay more than twice as much as other, more social countries and the gap widened considerably over BushCare.

In Canada they pay 4,000 a year each in taxes to support the health care system and that's all. In the US we pay 4,000 a year each in taxes for the right to pay another 3-4000 a year in premiums and out of pocket costs. Decided which system is better is a simple matter.

Oops. You can't edit these. That should obviously be deciding, not decided.

One other point. Insurance premiums should go up because many of the less expensive policies today are basically outright fraud. If you have a short term policy ending on Dec 31 and you discover on Dec 20 that you have cancer, then guess what? You have 10 days to cure your cancer under insurance before your policy ends and you are not able to buy another period of insurance because of your pre-existing condition. With a pre-existing condition guarantee, these policies become meaningless because the savings come from being able to boot people just when they need you most.

>>Beginning in 2014 small group medical plans will be subjected to a deductible cap - these plans will not be permitted to have an individual deductible above $2,000.

I would submit to you that this will impact up to 59% of small group PPO plans and nearly 90% of the HDHP/HSA plans. Employers and employees will both see their premiums increase because of the forced reduction in deductible.

You could certainly be right about this.

And yet if you're a small business owner who pays all the freight on health coverage (which I do; I'm a contractor), rising premiums may not be your worry.

Or at least it isn't my worry. As an S-Corp, I write off 100% of premiums paid as an employee benefit for our little operation.

Where we get crushed is in out of pocket costs, which aren't fully deductible. Thus, under Obamacare, it behooves us to pay up for the best available plan and let the feds pay part of the freight (in reduced taxes) and limit co-pays, deductibles, etc.

The irony? We're moving back into buying more insurance as a consequence of the new law after years of seeing skyrocketing health insurance costs during both the Bush and Obama years.

Your own mileage may vary, of course. Just relaying what's been my experience after a decade of self employment.

Mr. Williams' article states that this legislation was crafted by Obama and lawmakers. This comment is not very honest. It was crafted by Obama and Democratic lawmakers, with no input allowed by Republicans. And therein lies the problem. Both parties wanted to reform health care, but only one party was allowed to participate.

And Obama declared emphatically that all Americans could keep their health care plan. That obviously is false. And he promised that the ACA would not include people who live here illegally. Let's see if he keeps this promise.

I don't understand a lot of investors. When you invest in a company do you not check out their management? Do you not look at how they have handled their finances for the past several years? Or, what their financial situation looks like today and likely will tomorrow and beyond? Perhaps you try to discern whether they have successfully delivered their respective products and services in the past?

So, given a government that is (by any reasonable accounting standard that would be applied to a business) bankrupt. Or, if you don't like the word bankrupt surely you can at least admit the U.S. has a very poor LT Debt/equity ratio and very little room for the equity portion of that equation to improve, no? The president and congress as a combined management team have, for a lifetime or more, been very good at misappropriating and mismanaging the government's finances. They have given us SocialSecurity, Medicare, Medicaid, and the U.S. postal service, all of which, while they have pockets of usefulness, by any reasonable corporate measure have to be deemed failures, right? Why would you want to invest your money (taxes) in this bunch with their promise of streamlining and improving health care? A field, by the way, in which they already have an abysmal track record. It absolutely makes no sense to me.

Of course costs are going to skyrocket. Of course quality is going to suffer. Of course the whole mess will become more bloated and dysfunctional. That is what the federal government does.

There are problems and they need solutions, but we have just picked an entity with one of the poorest track records on every front to manage the situation for us. Doesn't take an Einstein to see how this turns out.

As someone that has worked in healthcare for over a decade, the articles make me face palm. Talking about healthcare and not talking about the effects of preventive care is like talking about stocks without talking about taxes. You are leaving out such a key effect that impacts the true underlying financial costs.

The net effect of preventive care that will happen as result of Obamacare will save us all significant costs. Denying that is like denying evolution, it's trading science for dogma.

We've always had universal healthcare, it's called an ER visit. It just costs the rest of us exponentially more than the preventive care. And it is the stupidest way to go about it.

My wife has a serious cancer. Thanks to the "efficient" free-market US health care system (as compared to Europe etc), our out-of-pocket medical expenses for the past 3 yrs have been $50K, $180K, $130K each year. This is all based on the *already* existing legacy supposedly "more efficient free market" system.

Because her cancer is a rare one with only 800 new patients per year, the for-profit only pharmas will never develop drugs for it. The best hope, recommended by a top oncologist at the "non-profit" MD Anderson cancer center (whose CEO makes a base salary of $1.4 mil) is BMY's Yervoy. This is an immunotherapy based drug that may theoretically work for many cancers. Since there will never be financial incentive to validate Yervoy for a 800 person per year cancer, we have to pay out of pocket. The drug costs $120K. MDA, as a "non-profit", will mark up 400% to charge us $500K for 4 initial infusions (many patients get many more than 4 infusions). Thinking that it was just MDA's problem, we approached an oncologist at a local clinic (also a "non-profit"). They wanted $900K but said we'll give you 30% discount, coming up to $600,000 for 4 starter infusions. Even after selling the house, there is no way we will be able to afford the drug with the meager savings we have left after the past 3 years of exorbitant out of pocket expenses,

Before my wife got cancer, I was a firmly republican. After diagnosis, as medical costs forced us to sell the house and deplete a majority of our entire life's savings, I have gradually changed my views. I now feel that the republican platform plays off basic human greed to hoard wealth to one's self. I don't blame them. I was there and I understand it. It appealed to me when I was healthy and in a position of strength. It's just human nature. But being in the situation we are now in, I feel that it truly sucks not to have universal health care that almost every other modern country in this world has. Not having that safety net truly makes me feel insecure about my future. Not only do we have to try to survive the cancer, but we will have lost almost all our life's savings because there is no safety net. My wife and I have been hardworking honest folk all our lives. We both went to great universities (she has a PhD and I a masters). It's just unfortunate that to survive, we've both had to quit work and focus full time on her care. The point is we're not one of those supposedly "lazy people" that republican media always talks about. We were firmly educated middle class folk well trying to live the american dream but derailed by unexpected health needs. And with the predatory pre-Obama health care system in place, our entire dream has been destroyed.

I truly wonder how many republicans on this thread will change views if they had to go through what my wife and I are going through.

On a related note, I believe that the US health care is a massive bubble. I believe the root cause is the fundamental discrepancy in regulatory framework. On the one hand, production of drugs and devices are extremely tightly regulated. So much so that even if we have cheaper and better alternatives (such as cryoablation being superior to radio frequency ablation of tumors in many situations), they are simply flatly denied reimbursement because "they haven't gone through clinical trials". We all know how much it takes to push something through a clinical trial (approx $1 billion). This limits the choice of drugs and procedures and devices we can use to what large pharmaceuticals decide to pursue.

It seems to me that the arguments made for "free market" forces to decide prices in health care are severely flawed because of this tight regulatory framework on the "production side". Basically, pharmaceuticals and hospitals are charging whatever they want to a captive customer base (anyone see the Time piece where paper pill cups cost a lady >$5000?).

Therefore, it seems to me that the only way to slow the bleeding is to impose severe price caps on health care reimbursements. Those who argue that the free market is best should look at the evidence objectively - that prices have only increased yoy way before president Obama's initiatives.

We truly need someone to protect use from the these captive local monopolies that hospitals and health care have become (believe me, when you have a fast growing tumor in a tricky spot near the brain, you *don't* have time to go comparison shopping! .... and even if you did, there are only X number of surgeons who can do it correctly). It seems to me that only the government can protect the 99%. The only other alternative I can think of is to *completely* eliminate all regulations both on production side (get rid of the FDA) and also on the consumption side. We all know this will never happen. Hence, a tradeoff comprising of *reasonable* regulation on both sides simply has to occur IMHO.

Moving on to investments, I believe that companies exposed to healthcare are vulnerable. When the bubble cannot grow any more bigger, when there is no more money left to be stolen by the health industry, there will be a reckoning. I believe we are already seeing beginnings of this with questions regarding ISRG's cost/benefit advantage (my wife had lung surgery with their machine & I don't think there is any real advantage except cosmetic. In fact it is slower to operate because of the setup time, and some surgeons (such as at MDA) are concerned about port site seeding of tumor using thoracoscopic and hence favor open surgeries - basically the advantages of ISRG's robot are likely not proven aside from the "minor" advantage of cosmetic benefit).

These are just my honest 2 cents. Having gone through this cancer ordeal, I have been forced to be as intellectually honest and objective as possible to try to beat the 10% odds of survival. I encourage all readers here to consider that we live in a society, not a free for all feudal-times state where the warlord gets it all and the peasants are left to die. I feel that this is what US healthcare system has become, pre-Obama, and it is clearly a result of monopolistic manipulation by entities seeking profit.

While I place great value on free market competition, I strongly believe that healthcare, with its intrinsic need for regulation, cannot and should not be treated as any other market for discretionary products and services.

I can appreciate your personal story, opinions, and heartaches. If you're willing, email me (so I can get your email address), because I may have some suggestions having been down a similar road with my mother a few years back.

ec777 I hope and pray you and your wife are ok. Realize that I'm sure even those you and I disagree with on this post who think Obama is a socialist, still feel for your story. A little humanity is often what changes peoples perspectives. Look at Senator Rob Portman on gay marriage after his son came out of the closet. When it affects you, you change your thinking.

Nothing new. I kept saying it. France wasn't able to control healthcare costs with their system. (I'm French.) And they have price controls all over the place with doctors and drugs. Now they mandate the purchase of additional private insurance to cover costs in addition to what the gov provides. Because the gov provides less and less since all that system is costly, had a cost on the economy in terms of taxes and other regulations, etc...

And the quality isn't that great. Medical workers like nurse and even doctors are underpaid.

First, Nothing is free. Second healthcare cost will always be out of control when it involves making profits. There is no easy answer because everything in life comes down to who gets stuck paying the bill. But whenever you force people to pay into a flawed system it will only make the rich richer. What sounds like a fix is really not. The only true way to control cost is to take away profits and excessive salaries. Good Luck with capitolastic socialism.

The estimated cost of every Federal program has been grossly understated. Medicare, Prescription Drugs and Medicaid are all multiples of what was projected. Anyone believing cost projections from the CBO is a fool. Why? The CBO only uses the data provided by the politicians. Obama used 10 years of increased taxes with only 6 years of Obamacare to claim the program would reduce our ever-growing federal debt. HAH!! Already Obama's staff is confirming that insurance rates will increase, but claim things will improve "in the future". Obamacare is a disaster in the making and I hope it is put to an early end. A recent report suggested it will add over 2.5 TRILLION to our debt, unless changed!

I don't think asking the insurance companies and medical device manufacturers what they think of Obamacare is going to give you a fair assessment. Ask someone who isn't covered by HC. Does anyone remember what lengths insurance companies went to to deny coverage? As for employers, I love that Papa John's CEO apparently believes that providing healthcare for his employees isn't somehow worth $0.11-$0.14 more per (crappy) pizza? Read T.R. Reid's book on healthcare -- highly recommended -- and you will see that virtually all other industrialized nations provide healthcare for their citizens as a right. 21,000 US citizens die needlessly every year bc they don't have adequate HC. 32 million more people will have access to healthcare. Kids up until 25 yrs of age will be covered. People won't be denied HC bc of pre-existing conditions. And, according to the CBO, repealing Obamacare as the GOP is so fixated on would cost $109 billion from 2013 to 2022.

The Republican critics and like minded tea partiers always fail to include the accustomed increases in health care costs. And no one is looking at the charges hospitals add to our bill to cover the treatment of uninsureds. The benefits of health care treament as opposed to crisis health care are well known, but somehow fall off the computations.

The pre-Obamacare medical system was a disaster. This new system is not perfect, but it is better and a step in the right direction.

What I don't understand is why we do not have a single payer plan in the US. If this is such an awful socialistic idea, why are all these US companies running overseas to countries that have it? It costs well in excess of $5000 per year to insure a single employee, far more than that for a family. Businesses shouldn't have to carry that burden, individuals should.

The ultimate goal of ObamaCare is to destroy the insurance companies and end up with government controlled/provided health care. We will end up with rationed health care and a lower qualityhealth care than we have now. Costs will ultimately rise because government is the least efficient at allocation of resources. For now we will have to put up with less choice as to what type of policy is right for us as individuals and our families and substantially higher costs. The whole thing goes against the countries founding premise of individual freedom. God help us we are becoming Europe.

Some how in spite of all this moaning and groaning, it seems that when everybody is insured and everybody is paying, the cost should go down, that's the way insurance works, it's also strange that even though there are so many people hating Obama, the guy that ran against him thought that universal health care was a good idea that's why he enacted it in Mass.

There may be a lot of political comments but that is surely not what this debate is about. Republicans only care about defeating Obama...Democrats only care about defacing Republicans and making them out to be "un-electable." That never changes.

What does change is our paychecks, retirement accounts, supermarket expenses, doctor bills, etc. That's what this debate is about. Your comment is worse than any pro-conservative/Republican on this board.

It is a waste of time to respond to this article. The people that support Obama are going to support him all the way to the poorhouse. The people that don't support him are going to complain about him all the way to the poorhouse.

Either way we are all going to end up in the same place. The nation accelerating itself into bankruptcy is hardly an endorsement of anybody's policies.

You ain't seen nothing yet. This boondoggle will cost everyone much more than what the conservative Society of Actuaries have estimated. What can't be estimated until it is well underway is the participation rate of all those people who are not in the system. Given human nature, this will be much greater than anyone imagines especially since the pharmaceutical companies, hospitals and docs are will make a ton of money.

Aaron Lesher prepared a very good presentation for staffing companies. He advises companies on their benefit plans, but he doesn't seem to have a huge conflict of interest; and in any case his conclusions seem acurate given the profit motive and human nature. He concludes that small (staffing) companies will be inclined to pay the $2,000 "tax" per employee rather than provide them expensive coverage. And healthy people will pay the $95 per year "tax" rather than pay an average of $225/month for coverage. SPOILER ALERT: if you own a small company wanting to provide health coverage for employees, this article will give you pause.

The health insurance increases in the past 2 years since ACA waas adopted are just doing what they've been doing for the past 20 years- rising by 15-30% a year, It isn't just since Obamacare appearred. I have a small businee that has had 4-9 employees over the past 17 years where I provide (pay) health insurance. It costs over $10,000 a year per employee now. We have been paying top dollar with crappy results- we've been raped for years. This has got to be better

I was an electrical contractor for 35 years (10-15 employees) and always provided health insurance for everyone I employed.

The fact that I did this (many of my competitors did not) meant a little less money for me but . . . I lived very well. Put the kids through college with no student loans to pay off, took vacations, no worries about paying bills, enjoyed life.

My competitors could have done the same.

This is not rocket science, it's all about greed.

Still enjoying life to the fullest at age 78, thanks to the money we accumulated from our business over the years.

I always chuckle when I hear people railing about government regulations killing small business. The cost of regulations was never more than a blip for us even though electrical installations are pretty tightly regulated, as they should be.

When ever the government says it is going to improve anything, you can count on it costing more, being in effective and ultimately be worse than the original condition.

The medical industry needs a drastic overhaul and until there is true competition in cost for services and drugs there will be no real change. Insurance companies should be allowed to participate across state lines, tort reform is needed to reduce doctors' and hospital liability cost and entitlements need to be reigned in.

The whole approach of over billing and settling for reduced fee is fraudulent and leads to ever increasing cost. The fact that a doctor's office needs an army of clerks to handle insurance paperwork screams of inefficiency..

To reduce health care cost, eliminate and limit the lawsuits payout will save at least 10 -15% of the health care cost. Doctors will not prescribe all kinds of unnecessary tests to protect themselves.

Let the patients to shop around. Patients have to pay up to a certain amount. When you buy a car do you pay $30,000 first to find out what kind of car you would get?

We set up a single premium so that everybody pays the same. In auto insurance we have 0, $300, $500, $1000 deductible based on our tolerance. We should have the same in health care in which younger people pay only for catastrophic protection.

We should let insurance companies compete for our business.

If we follow market approach, the saving can more than able to pay for the uninsured people.

As it is now we do not know the cost for each procedure and we don't care because a third party pay for it. Do you shop around when you buy a car to get the best deal?????

There are a number of simple things which could have been incorporated into Obamacare which could have helped keep healthcare costs down. Here are five ideas for starters:

First of all, mandating a cap on the amounts that can be paid out in malpractice claims could have been capped costs at a reasonable level, that would have reasonably compensated injured for losses, while preventing excessive payments which drive up insurance costs for physicians. We the consumer pay for this as a significant part of our health care costs. Remember the vast majority of doctors are doing their best to treat their patients the best they know how. Should they really be sued for unintentional errors unless they are really negligent?

Secondly, the party who loses a law suit could pay the costs of the law suit including lawyer costs for both parties. This would reduce frivolous lawsuits that end up costing us money for no benefit.

Thirdly, for health insurances mandated by law or those that are paid out of tax dollars, there should be large deductibles which the covered individual pays. Increasing deductibles would greatly reduce the cost of these health insurance policies. One mostly needs health insurance for catastrophic events. Most people can afford the occasional visit to the doctor or the payments for minor medical procedures. Also there should be a larger choice of deductibles available for policies bought through employers or bought privately. Availability of policies with larger deductibles would greatly help individuals control their own medical costs on an individual basis..

Fourthly all public employees including Senators, Congressmen, the President etc should be subject to the same medical care coverage at the same cost as the rest of the citizens in this country.

Fifthly, low cost health care clinics should be folded into the health care system to allow those in need of medical care but who cannot afford it to be covered for their health care needs without excessively burdening the taxpayer.

Many countries have universal health care and it costs them far, far less that we in the U.S. have been paying both before and after Obamacare. If we actually allowed "free enterprise" to bloom in the healthcare and insurance industries you would see remarkable decreases. But you know the insurance companies and the healthcare providers aren't going to allow that.

The 32% increase is not good, but it is peanuts compared to the other way Obama effed the country over. Just wait till obamaflation kicks in. He'll be long gone and happily traveling the world. We'll be stuck with his bill(deficit). And the $80billion a month he's been spending will devalue the dollar so bad that 32% will mean nothing.

The real problem, is that we forget that Obamacare is really the creation of a new huge market. True its being translated from an existing but well understood one. Now its going to have insurance pools, forced coverage, penalties, etc...that both the sellers (medical establishment) and buyers (us) are confused and unsure how its all going to work. Will it be good for buyers? Or good for sellers? Or both? Don't know, but its worth billions.

My wife, an otherwise healthy 61 year-old is already facing the most expensive pre-65 healthcare expenses of her life. She just got a 47% premium increase from Blue Shield of California! Like me, she is one of the millions of self employed non-group coverage participants. As fellow investors, the only way I see to help offset these ridiculous expenses is to keep investing in the stocks of drug makers and insurance companies. Anybody got any better ideas?

Naturally, this was going to turn into a left/right debate. How common this is today. No one can see any redeeming qualities on the other side. What else is new? Let's not forget that before "Obamacare", health care costs were skyrocketing every single year. This isn't news. Below is a link that explains why healthcare costs are as high as they are and what can possibly be done about it. Guess who isn't losing money while the rest of us are essentially making less and less money each year due to healthcare costs? That's right. The hospitals and insurance companies. They're like any other business. They're out to make the shareholders happy. If that's at the expense of your health, so be it.

I can't think of any other business where I can spend tens of thousands of dollars and still not know what's wrong with me. Isn't that fascinating? Wtf am I paying for? A service? If your service does actually nothing for me, then guess what? That's not a service.

Commenting on the costs of "Obamacare" without citing what the costs would have been without it are pointless and very misleading. Those who have indicated we are paying for the costs of the newly insured now, but at a higher rate, because they go to emergency rooms rather than other healthcare facilities are spot on! Do you really think Obamacare's costs are more than the overhead charged by most health insurance companies? The more we reduce that overhead and the use of emergency rooms, the better!

I am sickened by this article that is a sham in support of Republican scum sucking dogs! As a Motley Fool subscriber I am aware that money supplied by the healthcare industry must encourage businesses to hammer anything progressive. But I feel like this business should refrain from political stance taking. The American people voted in support of a better healthcare option and Motley Fool will stand in opposition to anything not championed by the wealthy. Makes me sick. I am a Montanan and i agree that Senator Baucus failed to represent his supports on this issue.

The system has failed not Obamacare. The question is not who is going to pay the costs, it is why are we paying such high costs.

The true question here is why are Americans accepting health care costs that are not related to true costs. Why are non-profit institutions making excessive profits, whilst their staff are paid massive salaries, why are they building large edifiices, whilst their neighborhoods are crumbling around them.

Why do they steal from so many to pay so few.

These are the questions we should be asking, which Obama should be asking.

Stop think and nationalise the healthcare system before it bankrupts you and the economy.

Healthcare is a shared responsibility. Why should people be raped by the Hypocritical health care system and pay these egregious prices?

Another caveat: The Society of Actuaries contracted Optum, a subsidiary of UnitedHealth Group, to do the number-crunching that drives the report. United also owns the nation's largest health insurance company. Bohn said the study reflects the professional conclusions of the society, not Optum or its parent company.

Stephen J. Hemsley, the UnitedHealth Group CEO, saw his pay cut by more than half in 2010, but still cleared $48.8 million.

I subscribe to Fool for investment ideas not to hear Fox News... Waste of time to be for or against ACA it is here to stay in some fashion. If those in Washington would begin working together maybe this can be refined to find a better solution. All 30 million are not drug addicts, my daughter teaches as an adjunct teacher at two colleges and due to prexisting condition could not get health insurance until ACA was enacted.

The real issue with the ACA (like most things involving Congress, the President and the Supreme Court) is that it is not authorized under the Constitution which is the suypreme law of this country. I know mentioning the Constittution will immediately get me branded a looney, fanatic. But if people would only read the comments by the framers of the Constitution which expound on the meaning and purpose of the "general welfare" clause, they would see that Congress lied to the American people (no surprise) to usurp powers and authorities which it was not granted. And the Supreme Court justices used their own interpretation instead of that of the writers to force their own beliefs. For example, Jefferson's letter to William Giles or his Opinions on the National Bank or Madison's letter to Andrew Stevenson.

Much of what Congress is and has done for decades is not authorized to it by the Constitution. Of course, local and State governments are free to set up welfare, education, health care and the like - but not the federal government. The answer is not this phrase or that regulation of the ACA, but the fact that it like so much else is unlawful for the federal government to inact.

If you need and HAVE to have a prescription for "Quinine" it will cost $100. for 30 tablets (Generic); or $200+ (Brand)?? You CAN GET 40 Tablets of "Qunine" (Cinchona), OVER THE COUNTER for $7.00?? 1 out of every 10 people can legally qualify for "Scooters" & "Hoveround" thru Medicare but....??? This is WHAT the "Affordable Care Act" is about!!!

I'm sorry to say, but the definition of USA politico/social system I developed forty years ago is "Institutionalised Anarchy", And a lot of the postings on this topic simply confirm it.

As an educator, my experience is that the USA education system is way to focussed on the individual and this precipitates the type of myopic responses that create the stupidity we see in debates between the R and D parties, or the inability to address real concerns, such as gun control and medical costs. People become incapable of seeing the big picture.

ec777 certainly has a very good example of why the country needs a medical service that does not leave people open solely to exploitation by greedy medical businesses or medical professionals. As do the comments here from some people inside the system. But, as EC777 admits, he did not comprehend or care about the situation till he was immersed in it.

Just like a lot of people do not seem to care about gun control till they, personally, are victims of the problem.

This inability to consider the broader picture or the consequences for others is also the root of the World Financial Crisis; many people in banking, accounting, as auditors - and no doubt actuaries too - focused solely on their personal gain at the expense of everyone else and the society. As we have seen the last few years, this self-centred focus eventually brings everything to a crashing collapse, and we all suffer.

Doctors have the big (financial) advantage that they are legally permitted to sign death certificates. Where do most people in a western society die - in hospitals. The medical industry - doctors, administrators, drug companies, insurance companies etc - can very literally collude to bury their mistakes. The cost to the community of the present system is not just the cost of medicine, it is the opportunity cost of losing people who could make useful contributions to the world, society, the people next door, or to you personally.

The same applies to all those children who died uselessly in the last stupid gun crazy killing spree.

But the potential to avoid all the medical industry sanctioned deaths, and the gun industry sanctioned deaths will be lost because too many people can't think beyond their immediate, myopic, short term, personal benefit. They have still not realised we are all connected together and problems for one will eventually come around to be problems for us all to bear.

Have the people who were given the sub-prime loans paid their bills? No, the rest of us have; one way or another. Did the bankers who sold the scam and deliberately flawed loans pay the bills; no, they walked away with their salaries, bonuses etc, leaving the cost to be borne by bank depositors, retirement funds, the taxpayer etc. We are paying the bills. They walk away. But they are now stuck with a sluggish economy, depressed home prices, no job on Wall Street etc. What goes around comes around; one way or another.

For example, we are all paying a part of the 480 billion fine slapped on HSBC for laundering Mexican drug money. The bankers who made the decision to get into that business - to raise business profits so they can claim a bigger salary, bonus etc - are not paying the fines personally; we are through lower interest on deposits, lower services, higher rates on loans.

As a few writers have mentioned on this medical insurance scheme debate, the taxpayer is already paying the cost somewhere; it's just not being made clear because the people who want everyone to be afraid of this system have a personal vested, financial interest in keeping the information hidden. That's "Institutionalised Anarchy" in operation.

Way too many people focused solely on their short-term, personal benefit and unable to take a bigger perspective.

How many more children need to die in their classrooms before society can take a wider perspective? How many more premature death certificates signed in hospitals before we have the compassion and wisdom to stop it.

The free-enterprise capitalist system serves the community very well in many areas, but there are areas of society where it does not. Health care is one.

Why do a lot of tourists not visit the USA? Because the cost of medical care - well before Obamacare was thought of - is way too high. Insurance premiums for travel to the USA are massively higher than for any other place in the world. The USA is already the most expensive place in the world to get sick. That's the consequence of the present - free enterprise -medical industry. A lot of selfish, myopic people exploiting others at a time of weakness and vulnerability. And the country that very clearly demonstrates it's lead in this myopic selfishness in the entire world is the USA.

"Institutionalised Anarchy" means there will still be a lot of people with their present personal financial benefits at risk who will keep pushing out negative information about the potential benefits of fixing the corrupted medical industry. Just like the bankers and finance psychopaths are complaining about their industry being fixed; to protect the broader community.

If only more people could comprehend that when you exploit, abuse and kill other people, eventually the consequences come around to bite you on the bum. Which is why medical costs in the USA have - for decades - been known to be the most expensive, prohibitive, and deadly, in the world.

That's the very clear and very world leading position of the USA medical services industry for at least the last five decades. A lot of people do not want that changed because they will no longer make as much money for themselves. The corrupted free-enterprise system in action; death and suffering for millions to satisfy their personal financial greed.

I am a small business person who has always supplied med. ins. for my employees. The rates have shot up since the passing of the affordable care act, and yes they are rising faster then ever before, and yes i really know that this is a fact. Passing a law before we read it in order to find out what is in it , is always a bad idea.

The parts of the act that are good, coverage for people that couldn't get coverage, allowing children to stay on their parents insurance longer, are things that could have been done without turning our healthcare on its head. what are we going to do when the gov,t actuaries decide that since you are 69 and life expectancy is 79 they should not pay for you to have a hip replacement, knee replacement , chemo therapy, or any other expensive treatments.

I think a better way to approach problems in the system (a system that worked very well for 90% of Americans could have been modified by a more modest bill that actually dealt with the problems and was concise and understandable. that din't require hiring 15,000 I.R.S. workers to oversea, that didn't leave so many things to the judgement of unelected officials. N.Y.State had already allowed for children to be covered under their parents healthcare past age 26. did we need the federal government to create a whole multi-billion dollar burocracy , did we expect that all those new hires to force compliance and to make new rules that will eventually interfere with every part of our lives, would cost nothing,

Yes the costs are way higher than the overhead charged by most insurance companies.

The mayor of N.Y.C. now gets to interfere with how we eat, how we travel, how we excercise, because health care is now the gov'ts expense.

the costs of healthcare were well known before Obama care , and we are only beginning to see how high they have become because of Obama care.

I have to wonder about the thinking processes of people that think a bill has to be so complex that the people that pass it can't read it and understand it, and that the defenders of it defend it on the basis of what think might be in it rather than what is in it.

There are ways to cut Health care expenses and to make them available to all Americans, but Obama care does it in such a way that congressional leaders had to lie to the American people about what the bill would to and about what it would cost

We need to rein in healthcare... treatment should be 'efficacious', as the doctors say, but it often isn't.

We need government sponsored healthcare for the procedures that will bankrupt regular people that can't pay for them, and THAT WORK (!). Cancer treatment to extend life a few months at a cost of 5 years wages per month should not be considered.

New knees are a great technological advance, but if we all want bionic bodies, it will be expensive. I'm not in favor of making 100 people that don't get new knees pay for the one that does. Doubtless those knees make life much easier for that person (who is often past or approaching the end of their working life), but society at large needs to be careful about who benefits (a worker, or a golfer?... should we have old age green fee insurance?).

I'm in favor of a reasonable healthcare program at the national level. One that encourages regular visits to a primary care physician, and helps people stay healthy in a low key way (perhaps even an annual fee cap). Don't make this out to be my desire to restrict your health options. You are free to use your money to buy the expensive, non-efficacious procedures you want. I'd rather you didn't make me pay for them though.

My desire is to make the healthcare industry (of which I have been a part of for thirty plus years) live by the market signals, and stop selling fear (of death in the case of cancer) and entitlement (in the case of knees). Insurance really fouls up the market signals - especially when the healthcare recipient doesn't even do the shopping for the insurance!

I haven't read all the comments, (especially since many were worthless rants about the PPACA), but one topic that I have not seen mentioned is that--

where are we going to get a whole lot of new doctors to take care of 30 million new patients? Even adding in NP's and PA's, I doubt there will be enough qualified care-givers to deal with the huge influx of new patients. In my geographic area of practice, most primary care doctor's are not taking any new patients--their practices are already full. I am predicting that there is going to be a severe shortage of MDs.

A.C.A. "Affordable Care Act" is about; "Quinine"; if you need it and have a prescription you can get 30 tablets Generic @ $100., Brand @ $200.+ OR "Over The Counter" Quinine (Cinchona), 40 tablets @ $7.00. Next example: "Scooters" & "Hoveround"; 1 out of 10 are legally qualified under Medicare, but...?? A.C.A. IS NEEDED!!!

As an independent and self-employed family man for over 28 years, it was refreshing to see the POTUS actually try to improve upon our healthcare delivery system. Over the last twenty years, premiums have climbed, deductibles have climbed and coverage has shrunk. The ACA isn't perfect, but it's a damn sight better than the Republican plan aka "don't get sick." It's time we start getting something for our money besides bloated so-called non-profits, ridiculously compensated health insurance, hospital, pharmaceutical and medical device company executives. Too many politicians are wed to the medical-industrial complex and have no interest in reducing our health care costs.

Interesting article. One thing I note about the SOA report and those who trash Obamacare - they never mention the fact that the parh we were on was unsustainable and the quality of care was diminishing YOY. I am neither for nor against Obamacare. But as an executive who runs a fairly large organization I know that when something isn't working it has to be changed. Obama may prove to have not gotten this right but it's hard to believe it is worse than the spiraling cost of healthcare before the legislation passed.

The fact remains that Obamacare will not work, but we can bankrupt ourselves trying to prove this is not so. Some thoughts:

1.In my experience and I deal with tax law every day, every page of legislation normally brings with it at least 5 pages of regulations. Do the math.

2.We still do not know what the law will be because most of the legislation will be crafted by bureaucrats and that will take years. The uncertainty of this will continue to cost us billions of dollars.

3 The law is the creation of the democrats who controlled the Legislative and Executive branches of our government when the legislation was passed. The law is flawed, where is the tort reform the lack of which has been responsible for a significant portion of the increase in all medical costs?

4.Those that say that over 30 million people will now be insured that were not insured before should ask themselves where are the physicians that are going to take care of them and us. When was the last time you tried to make an appointment with a doctor and where told to come that same week to see him? Do you think that doctors will continue to work while limits are placed in their compensation and they are saddled with all types of bureaucratic nonsense?

5.Insurance should only cover those things that you can not pay yourself, and the government should only be involved in providing assistance as a last resource. Furthermore, the government should not be involved in providing that assistance directly by the use of a bureaucracy, instead they should channel the assistance through organization that have experience in doing it while they provide the oversight necessary to avoid abuses of the system.

6.Look back to when the medical costs started going out of control, and you will find the hand of government all over it. I not only mean the federal government, State government has also had a big hand on this mess. Why can’t you have the type of policy that only covers the risks that you are not willing to pay out of your own pocket?

7.For those that talk about Canada’s plan, I have a question, how come that when a Canadian has a critical problem he comes to the US for treatment?

8.What is going to happen when a government bureaucrat starts telling the physician (as it is starting to happen now) what treatment he can give to a patient? What is going to happen to those that the same bureaucrat feels are too old to have an expensive procedure? Will they be treated as well as those that are in jail for committing crimes or are here illegally?

Obamacare is the result of good intentions, but I always remember what Daniel Webster said; "Good intentions will always be pleaded for any assumption of power. The Constitution was made to guard the people against the dangers of good intentions. There are men in all ages who mean to govern well, but they mean to govern. They promise to be good masters, but they mean to be masters".

Several of the comments, especially ec777 have been well thought through and rational. That's what we need when it comes to ACA. ACA is not perfect, but it's better than the "free market" that guys like Ryan want back. That system was broken but ACA has yet to go into full effect, although some aspects have. There is no longer a lifetime cap on what an insurer will pay. That really helps out when the 30K bill for the air ambulance gets in your mailbox.

Premiums always go up. They go up as we get older. With ACA and everybody paying something, and the insurance companies REQUIRED to spend 80% of premiums collected, that should help control costs down the road.

Having been a business owner for 25 years, I see things a lot differently than this very slanted myopic article. What I come to expect now from MF, very sad, Well Before Obamacare, you will recall 30-50% yearly increases by the Blue Cross/Shield players, as well as others. What they admitted to doing was culling out all the sick folk, and keeping just the healthy folks. However, without those sick folk, they had to raise premiums on the healthy (I was one), and the healthy folks told them to take a hike, therefore no $$.

Obamacare eliminates the Cap, allows folks to keep their kids on the policy until 26, and eliminate pre-existing disqualifications. Some insurance companies considered Pregnancy as a pre-existing condition. They git used to lazy money. If you have a family, OCare is going to help stabilize the costs. Mittens used to brag about his RomneyCare until he ran for POTUS. And to bring up dirtball Pappa John, what a joke. He has tons of money for football commercial, but heaven forbid he spend some on the health of the workers that made him rich.

I treated my workers as human beings, and though I could have made more if I were an A$$hole, I have enough to retire and try to make sense of the market, and my ex workers still like me.

After reading all these comments, I am reminded of how divided we have become in the last several years. I am divided from members of my own family. This health care bill was a crippling blow to our country in terms of our unity. At the time, I was completely immersed in the progress of the ACA bill. I read everything and listened to every source I could. As a Republican (and a citizen) I felt completely shut out of the debate. Where were the open forums on C-SPAN that Pres. Obama said we would have? Why couldn't we hear any of the ideas being debated when they would determine how my family would get care they might need to live? Why did Senators need to be bought off to secure their votes? And finally, why was this bill passed on a budget resolution with 50(60?) one party votes in back room negotiations. No wonder this has left a bad taste in our mouths. The half that voted for Obama was defensive and smug, the half that didn't felt like it was forced on them. I am not surprised at the mess this is turning into. We could have had so much better if our leaders had truly set out to improve healthcare in this country as opposed to just taking it over. Politics will be the death of us.

My preference has always been to buy affordable, sensible high deductible health insurance. Now this is being made illegal. We are being forced to purchase enormously expensive "insurance" with this law. I put insurance in quotes because much of it isn't insurance. You can't insure 100% probabilities like routine expenses and pre existing conditions. What this is is insurance companies using government force to make us buy much more of their product than makes any kind of financial sense.

For the first time in my life I am far from optimistic about the future of the US which is becoming just another society smothered by ignorance and central dictate.

Obama Care is not about health care. It is about Obama’s mother being ruined financially because of health care costs and dying penniless.

The Democrats passed it when they controlled both houses of congress with no input allowed by them from the Republicans.

Because it is “political pay back”, there was little common sense thought put into it. An example of this is the developing shortage of Doctors. There are not going to be enough doctors to treat everyone in a timely manner. This effectively makes millions of us “uninsured”.

So, we are still going to have millions without access to timely health care. The only difference is it is going to be most of the middle class in addition to the low income.

Finally, I’d like to point out that President Obama is a multimillionaire. This fact is constantly under reported by the media.

Just like all government programs (will always cost much, much more and deliver less and less quality) Obamacare will be absolutely no different.

As for one of the comments about there being a shortage of doctors was almost comical. For one thing, the AMA has completed control over which college programs are approved for medical training and therefore limits the number of schools providing such training. Plus, each medical school only admits around 100 new students each year. With a growing population, the effects of Obamacare prompting many doctors to quit, and the limited supply of new doctors, shortages will get much worse.

Such a sweeping policy of any kind will not be perfect and time will iron everything out. The main thing was to get going on this deal so we could get going to the tuning aspect. It should have been done 100 years ago before greed cast its ugly shadow on every aspect of our lives. We should also try humanitarianism instead of imperialism, us and the world may like it.

MiddlenameFrank's comments are among the few that made sense. We have been paying for the costs of the uninsured at inflated rates. Whether or not the Country ends up saving any money compared to what the costs are under ACA vs old system will take years to settle down because of all the current uncertainies about just what will happen as a result. Further, trying to estimate the costs of future medical care is a daunting task considering how medical care changes and the many advancements already made and waiting implementation plus those that will be made.

To me, the important thing is that we are all in this together and we should all try to help one another rather than leaving some in hopeless situations arising from health problems that generally they are not responsible for. (Sure there are those that could be avoided by not smoking, overeating etc.) Until recently the Country's history has been to aid one another in many ways. Unfortunately in the past two or three decades, things have shifted more toward a purely "what's in it for me" attitude.

Can everyone here leaving a comment understand that the very people that we have elected to Congress has the best Health Care in the country. These elected officials, the majority of them are and have voted against you have Health Care anywhere close to level that they have.

If our elected officials in Congress had the same Health Care that we have, they would be all about change. America needs to wake and demand the same Health Care Coverage as our elected officials in Congress.

But like Romney discovered as Governor: we don't throw sick people to the wolves, we treat them.

When Insurance is "optional" the GOVERNMENT pays every penny of care-- usually in an emergency room. That's the status quo.

I've analyzed Health Care from every angle. I've bought insurance through my employer and even through the MA Connector.

I've concluded that free enterprise capitalism does not work with health care UNLESS as a society you're willing to stand by and deny coverage.

Pure Free enterprise law enforcement doesn't work unless you allow police departments to ignore calls from residents who don't buy. And if society is willing to let non law enforcement purchasers be on their own.

ACA goes a long way in providing ACCESS...fails miserably in containing COSTS. It's a mirror of our situation in MA.

I've concluded that single payer is the only way to go. It sickens me (no pun intended) ideologically. But pragmatically it's the only real answer unless we want to write off the health of millions of people genetically or economically too sick or too poor to play.

By the way, even though I believe single payer is likely the least worst end game here, I totally agree that's its "last call" time for real reforms as brilliantly outlined in previous comments here, including Tort Reform, to save free market health care.

The present health care scenario/economics are failing miserably...ACA ironically only makes the economics of the present system more transparent (what it REALLY costs to treat people for FREE which we do NOW)....

So we do have one last chance to address costs and allow free market health care one last shot...or we inevitably move likely sooner than later, to moving the 60% not on single payer to the full 100%.

Unless repealed, Obamacare is a step toward single payer. All of the small insurers will be bought out by the large companies because of they can't bear the risk of the minimum loss ratio requirements. Four companies will remain and the govt will swoop in to "save us" from the lack of competition. Then we'll still pay these companies to administer the govt programs. We'll be stuck with a wasteful medicare type of program for all that costs more and entitles all of America. Bright side: We'll all be riding on Hoveround scooters at the the Grand Canyon!

The problem with all/most social programs is they never address the problem they claim to and never address the root causes of the problem. Add onto that the compete inability for the Gov't to manage anything beacuse of the lack of responsibiity and accountability and you have a corrupt mess. On top of all that you have the corruption of those that craft these programs. I doubt if any Gov't social program/social engineering/whatever.....ever worked. Meantime, the corrupt steal from taxpayers and line their pockets.

The rising costs of health care threatens to swamp the US economy if something is not done. Hopefully, Obamacare is a first step.

The US pays roughly double per capita for healthcare that the next highest country pays. That country and almost every non third world country in the world has universal health care. Some use private insurance companies, like Switzerland, some use government single payer systems, like Canada. Almost all of these countries are democracies. While there are tweaks to the universal health care systems, no serious political opposition to these universal health care systems exists. Massachusetts is democratic. If their health care system is so bad, why haven't they repealed it? Why haven't the Canadians repealed theirs?

If it weren't for the pharmaceutical companies and the insurance companies and their lobbyists and the money they give to politicians, we would have had some form of universal health care long ago, and we would be much better off.

Your article leads the reader to believe that health care costs are about to rise. You need to include the past three years. Our insurer has sent us the premium increase notices for at least the past three years with explanations like "because of added costs such as having to include children up to age 27". The increases did not just start. Yes, larger ones are coming, but you might have missed some we are already experiencing.

One policy has increased from ~$200 to $500 per month over the past 4 years with no change the in the coverage.

It really was a compromise law, and sad to say, not the best that could be done, but really all that could be done given the obstructionist GOP. As an American living overseas, I see healthcare systems the world over offering far better care at considerably less cost than what we get in the USA. It's simple enough to emulate any number of those--but we have a government controlled by special interests. Sad but true, and if I may say, when democracy is bought, it's not really democracy any longer. Most Americans want some kind of health care system. What we are getting is not nearly what we could be.

of course the ACA is doomed to fail by not controling costs, but when it does fail we will finally get national health care like every other industrial nation in the world, because that is the only way to control health care costs. a profit orientated health care system only leads to higher costs.

My father worked as a fireman WITHOUT medical insurance coverage. He was able to pay the hospital and doctor bills and bring me home debt-free for both a tonsillectomy and an appendectomy. Then the representatives we sent to Washington DC were wooed by big insurance companies. Now an uninsured patient is billed 400% to 500% of the amount paid by the insurance company, Medicare and Medicaid. Let's send a new bunch to DC and get back to paying our own way!

Lots of comments! Mostly negative by my random sampling. As a person working in the HIT industry for over decades, there is a lot of good happening with Obamacare. The results of this law - will reshape healthcare for the better. It is fundamentally changing the incentives for paying for care. It is shifting from paying for service to paying for value. There is a big provision in ACA for something called Accountable Care Organization (ACOs). Read about it, think about it and then complain if you don't agree with the principles behind it. The goal is to pay for quality of care - not quantity - which is the current model. Your physicians & hospitals will happily keep providing you service today - and charge you - whether or not you get healthy. Which industry gets away with that other than healthcare?

Not everything in Obamacare is fully baked - but with such legislation, it is expected to be revised and revised again. The same happened with Medicare and Social Security. That is no reason to throw the baby with the bathwater...

Suffice it to say, I disagree with the majority view here - complaining about ACA :)

Reportedly, the per capital cost of "universal" medical care in most developed countries ranges from 1/4 to 1/2 that of the US prior to ACA. If ACA is improved to approximate the experience of other countries, costs will decline, not increase.

Does anybody want to look at what happened in the last 20 years because we as a society did NOTHING. Yes, it is a mess. Yes, it has been a mess for decades. Yes, it will be a mess for several years to come. But you can't improve a situation if you don't FACE the situation. Maybe we can make the sitaution better five or ten years from now becuase we finally FACED it.

The problem with health care is third party funding which isolates the industry from market forces. Everyone is spending someone else's money so the consumer does not care about costs or efficiency. Enormous cost reductions are available if the industry had the proper financial incentives. Obamacare does nothing to fix the problem. The government should give consumers information about providers to enable informed choices and health care loans to be paid back with a 10% tax on disposable income. If people are knowledgeable and are paying their own bills the market will quickly enforce cost reductions. Prepaid health care (commonly called health insurance) is the problem and needs to be abolished.

If a nation state cannot put the health and welfare of its citizens as its first priority, then what is the point of a nation state? To many of you, the point of a nation state seems to be to create a profitable environment. Is that really the only reason we are a country? Because if so, that's an incredibly narrow-minded and miserable goal for a country that loudly proclaims to stand for so much more.

This is just bad judgement to run this article. While there may be tangential financial implications, this article has simply given a forum for largely ill informed right wing rants. There is no shortage of that rage available. With a little searching on that internet thingy one can find well researched information indicating how much money will be saved through the ACA.

When you read comments on most issues, it is easily understood why nothing ever gets fixed. I suspect 99% of Americans cannot comprehend math, economics, or the way systems work. In healthcare (as in everything else) you cannot have unbalanced equations.

You cannot insist we see more patients a day to stay even in income, even as we struggle to do a great job seeing 40-50 patients a day.

Once you allow the government to determine what profit any business or industry can earn, what stops them from doing this to many others, if not all? I personally dislike the entire insurance industry, but they are a business, in business, to make a profit. Singleing them out is total PC and the highest bunch or horse manure. Why doesn't our beloved fed demand the oil industry lower thier profits to 20%? Why don't they insist the lobbyists in DC earn only 50K a year? Right. It all depends on whom you're sleeping with. Has nothing to do with economics on a large scale.

Yep american healthcare is too expensive for many reasons. >> And will continue to be more expensive.

The original article Question is "lIs Obamacare About to Skyrocket Your Health Care Costs?

Well so far I'm lucky that my e,ployer still covers my cost. In 2014 I don't know yet.

My guess is that forcing, mandating , what ever bringing millions more people in to care that currently aren't paying will cause all of us taxpayers to pay more.

Essentially the government is in the same boat as insurance, lot's of people that they collect money from and realize they can't afford to pay for it,

Medicare was set up to last from -65 to life xpectancy 75. people are living much longer and spending more than they ever put into the system it's broken. Forcing ( taxing , Mandating) younger people to pay in teporarily will help them shift cost for older american's to younger.

Medicaret doesn't cover nursing home care

medicaid does seniors ar having to spend all they have at the end of life then apply for medicaid to cover nursing home expenses, The gov't doesn thave enough money to cover it. This law is about them controlling it more and being able to tell everyone you can't opt out. You can't go naked.

The y have set the profit on healthcare insurance companies to 20% not bad. Especially since they have now mandated 30- 47 million more have to get some type of insurance. Can you say windfall, and lobby influence?

It's almost always about money, power and control.

I say we have true competion and offer to outsource our healthcare dollars to canada, switzerland or germany, since our gov't doesn't seem to be able to handle the resposibilty of managing taxpayors money.

We have years to prove they can't fix it , and can't balance a budget. There is no cosequence for our represenatives if they don't balance. If they lost they're benifits and pay until a balanced budget was done it would get fixed.

Nobody ever seems to understand statistics. Certainly no one seems to ever understand the tyranny of the 2%.

People RUSH to give away all that is good, decent, and wholesome, for the good of the 2%, in exchange for all that is evil, deleterious and destructive.

We have health care in this country now that has problems, but on the whole is pretty good. We are gonna make sure that everyone has health care though cuz we have that pesky 2% that don't get the coverage they need for whatever reasons.

Btw, you cannot possibly cover that 2% without degrading the 98%. But commercials showing hurting people and especially hurting children are more important than considering the whole problem, so we rush to throw the baby out with the bath water. Or we have politicians who connive and do it for/to us.

Either way, we will end up with health care that is subpar and certainly below which we enjoy today. With a nice trend downwards to go with it!

It's just like education. Education used to be handled at the state level, as we were becoming the most successful country in the world.

But we had some states that just had horrible education systems. And worse we have pockets, 2% or so, of abysmal education going on in various states.

But we fixed all of that with the NEA and government standards and such. Now look at us. We generally score among the bottom of industrialized nations in standardized tests, especially in Math and Science.

But, at least we still have states with abysmal education systems (Arkansas I'm lookin at you) and at least 2% worth of pockets of horrible education all over.

I think it's interesting that the article doesn't subtract out the cost of health care that currently gets charged to tax payers because of uninsured people getting their health-care through emergency rooms -- perhaps the least efficient method for distributing non-emergency care, just because the ER rooms can't turn them down.

I agree that insuring 30 million extra people will cost us more money. But, to be fair, we should also discuss how much it will "save" us too -- totalsed across both government spending, and insurance premiums.

Other countries manage to provide for the health and welfare of their citizens far better than the U.S. I don’t know if the ACA was the best possible bill. Almost half of Congress was so focused on not allowing President Obama a second term that they would not help construct a workable plan. Lobbyists for the insurance industry pounded Congress, but the people don’t have a lobbyist. We got what the Democratic majority was able to pass with Republican and lobbyist opposition.

I live in the near-third world State of Texas. Our local taxes pay for the often too-little, too-late, too-expensive care given to the uninsured. Obamacare should improve that situation, unless our governor uses the National Guard and Texas Rangers to secede from the union. It may work better in places where the local governments cooperate and works for the good of the people.

Right now, we need to fix the medical care system in this country. Obamacare is a start. Maybe it will need to be adjusted, but it should not be killed.

(My preference – single payer. Maybe expand Medicare to everyone, paid for from the general fund, no special tax.)

Are you people crazy? I love all of these backseat drivers who claim all kinds of stats and facts without providing an example or source. Anyone who knows anything knows that "other industrialized nations" that provide universal healthcare have tax rates of 40-75% on EVERYONE. Not to mention waiting lists for major procedures and NO R&D because there is no profit in creating the next cancer drug or medical device. Big bad capitalism drives innovation and invention. It also funds it btw.

I read ec777's plight and while I can't imagine the sorrow and I pray for your wife, what makes you think that Obamacare is going to pay for experimental or "low experience" needs??!! They will regulate those right out the window. Some panel somewhere will decide if that rx is effective and/or necessary. And don't think for a second that ACA eliminates co-pays and deductibles. Insurance is still insurance- now you're just forced to buy a plan.

And for all the liberals who say we are already paying for universal healthcare thru ER's for uninsured, you're either ignorant or self-deluded. Yes we are paying for their trips to the ER, but the cost is not nearly what it will be when EVERYONE is covered and feels entitled to use their "free" healthcare for a mosquito bite, when before they used it only for emergencies.

Give it ten years under this system and you're not going to be able to find a doctor in the US. Why would ANYONE go to school that costs $200,000-$400,000 so they can make a government salary? It doesn't make sense.

Nothing about this plan makes sense. Trust me, I am an HR professional who is intimate with employer health plans. This system is going to rock unemployment numbers. Companies just can't afford to insure their employees, and they can't afford not to b/c of penalties. So what do you do as an employer? Lower your cost by eliminating jobs.

Obama loyalists need a dose of reality. this isn't about rightwing...it's about not living in a dream world.

And to all the "one-payer" proponents, we already tried that with medicare and medicaid. How are those working out for you?

My take is that Obamacare is treating a symptom of the actual problem. Sure, 32 million Americans are uninsured, but why? Providing them health care coverage doesn't take care of the root cause problem. The main problem is health care costs having increased well more than inflation for decades. So the real solution to the problem is to control health care costs at or below inflation. There are many reasons health care costs have increased, and I don't think any one person knows even half of the causes. But I would be willing to bet some of the greatest contributions to that cost are exponential increase in prescriptions, incredible advancement in technology of medical equipment which also increases costs at a fast pace, fraud, and no real competition. Having doctors in networks whereby the cost is negotiated down, but the cost is enormously high for someone without insurance, is really a cartel. That's right, I view the health insurance companies as cartels, plain and simple. Therefore it is nearly impossible for a person to NOT afford health insurance because not having it creates a ridiculous increase in cost. Unless of course, you have no money and just simply can't afford insurance, i.e. the bulk of those 32 million Americans.

So there needs to be a means to slow down the increase in healthcare costs or the problem will never go away, and Obamacare doesn't solve that problem.

"...While the report found that federal subsidies to obtain health coverage would be restricted to U.S. citizens and legal residents, it also noted that the bill does not specify a citizenship verification system.... Nonresident aliens would be exempt from the required coverage, but undocumented immigrants who live in the United States for a certain amount of time during the year would be classified as residents. "Thus, it would appear that unauthorized aliens who meet the substantial presence test would be required under HR 3200 to have health insurance," the report says.

It was less clear, however, how the mandate would be enforced for people, immigrants or not, who do not file federal income taxes." Fake ID anyone?

And from article "Illegal aliens will be covered under Obama's healthcare bill".......

"Mexico directs their citizens who live in the U.S. illegally, to use taxpayer funded clinics in a dozen cities. The program is called Ventanillas de Salud (Health Windows), and is implemented in American cities which have Mexican consulates.

"The government of Mexico has operated the program for some time. In 2007, Fitton wrote the following:

'Chicago, Houston, Los Angeles, San Diego and Indiana are among the cities where Mexican consulates operate the health referral system which annually costs U.S. taxpayers billions of dollars. In Los Angeles County alone, illegal immigrants cost taxpayers nearly $440 million in health services annually and a whopping $1.1 billion statewide.' "

"One major weakness in our efforts to secure the homeland is the Matricula Consular card issued by the Mexican government for use by illegals in the United States This card encourages illegal immigration through a de facto amnesty program and provides criminals an open door to commit identity theft and fraud – and even threaten national security

From opening bank accounts to traveling on airlines, a potential terrorist can escape terrorist watch lists to gain a stronger foothold in the country and has the opportunity to obtain additional identification including state driver licenses.

The Mexican government conducts no background checks and maintains no digitized fingerprint database of those who apply and receive the card.

These cards are easily counterfeited A member of the public, without my awareness or solicitation, obtained a Matricula card with my name and likeness Phony cards are readily available on corners near Alvarado Street and anyone can obtain one for under $30 in less than two hours."

I thought it was the better of 2 evils...& honestly still haven't a clue what Romney's proposal was...'vouchers??' I do NOW KNOW I dis-like Obamacare more with each passing day. As a matter of fact, I dis-like Pres. Obama more & more each day. Would I rather have Romney...Nope!!!...BUT...I'd like offer #3..i.e. Hillary. 2016 can't get here fast enough!! Geese, Bush left us a major mess. Now Obama's making things worse. Honestly didn't think that was possible...but he's proven me wrong...So Sad!!! Hope we're able to survive these two...whatevers??? Small note..I'm even more than sick of Michelle's bangs!! Seeing too much of her yakking on TV shows too. Yuck!

This is just more of government thinking they know better than individuals what to do, how we should live, and how we should spend our money. Something probably needed to be done to improve health care results and the assciated costs, but it should have been in small steps. Obamacare is a burdensome, huge bill, still being written by bureacrats, and one which no one fully understands.

Well, my no frills major medical basic health premiums have gone from around $400 per month up to $743. My internist had to give up his practice and join a large hospital. And last week my doctor said I needed and MRI of my spine but would only be allowed to take lower cost Xrays. Where is the $2,500 annual savings Obama promised? Repeal!

If Obamacare is so good, why does NO One who voted for it want to be in it-including Obama. Make the MAN and his family abide by HIS law and all it's rules. In fact, every employee in any government agency or dept I have heard from has opted out of the program. I rest my case!